« AnteriorContinuar »
ters, have been denominated INTERMITTENTES LARVATÆ, Gen. II.
Spec. IV. or disguised intermittents.
Anetus erraticus. Irregular ague.
PAROXYSMS INTRICATE, MULTIPLICATE, OR BOTH.
THERE are numerous examples of ague which, to an Gen. II.
Spec. V. inattentive eye, are as irreducible to any regular order as Analysis of those which belong to the last variety of the preceding its intri
cacy. species; but which, when minutely examined, are found, however intricate, to be composed of types, not that uniformly resemble each other, but that recur in alternate sets, every set being true to itself, while it differs from that with which it alternates in the duration of its intervals, or of its paroxysms, or of the time of its accession. And hence, although in some shape or other, most of them return perhaps every day, and are often mistaken, for irregular quotidians, they are, in fact, double or triple tertians, or quartans, discovering their real nature by these alternating distinctions.
The following are the chief varieties :-
tertian occurring in the in-
or of violence.
place as above; but one
Gen. II. y Tertianus impar, The one set evincing a more SPEC, V.
Double unequal tertian. perfect, the other a less Anetus complica
perfect intermission. ŠTertianus duplicatus. A single tertian with two cated ague. Duplicate tertian.
paroxysms on the regular day of attack, the intervals being of ordinary
duration. & Quartanus duplex. The paroxysms of the one Double quartan.
set occurring in the intermissions of the other; and evincing a difference of duration or of violence: with an interval on the
third day alone. s Quartanus triplex. Consisting of a single quarTriple quartan.
tan with regularly return; ingparoxysms; while each of the intervening days is marked with a slighter
or separate attack.. n Quartanus duplicatus. Consisting of a single quarDuplicate quartan. tan; with two paroxysms
on the regular day of attack: the intervals being
of ordinary duration. 9 Quartanus triplicatus. Consisting of a single quarTriplicate quartan. tan with three paroxysms
on the regular day of attack: the intervals being undisturbed and of ordi
nary duration, ili Having thus distinctly noticed the several species and chief varieties of intermittent fever, I shall proceed to offer a few remarks upon its general history, and medi
cal treatment. General Whenever the accession of an intermittent is violent, history of intermit- be its type what it may, it is sometimes attended with tent fevers. very alarming symptoms, as syncope, apoplexy, vehe
ment spasms over the whole system, or a coldness or Gen. II. torpor which threatens death. Yet, when not violent, i nor of very long duration, and especially when of the tent fever. tertian type, it is often serviceable to the general health, How far.
dangerous. and carries off many chronic and lurking disorders of other kinds :- Dr. Fordyce affirms that he has seen it of serviceable. considerable use in curing or alleviating chronic rheumatism, habitual indigestion, cutaneous eruptions, protracted inflammations, epilepsies, and hysteria *. And his assertion is corroborated by other authorities t. It Depuratory
fever of is to this kind of remedial fever that Professor Frank Frank gives the name of depuratory I. The duration of intermittents is of great uncertainty. Duration
uncertain. The vernal agues generally disappear with the advance of summer : the autumnal are more obstinate, and especially the quartaną. Where they have remained long, and have become habitual, even their removal must be attempted with great caution; for when abruptly suppressed, they have been known to lay a foundation for a host of other maladies, often of a more fatal description, as paralysis, various visceral affections, and even sphacelus. Ludolf gives an instance of an eight-day ague (anetus Has conti
nued erraticus octanus), continuing for eighteen years; yet thro this was probably a double quartan; while we have great part abundant examples of a continuance of the regular quartan for ninell, twelves, eighteen **, twenty tt, twentyfourtt, and thirty yearsgy, and one instance of it lasting for not less than forty-eight years I. II. It is in this spe
• On Fever, Diss. II. p. 16.
+ Salmuth, Cent, 11. Obs. 14.-Ephem. Nat. Cur. Dec. III. Ann. 111. Obs. 30.
J. P. Frank, De Curandis Hom. Morb. Ep. Tom. I. p. 48. $ Ib. p. 44. | Eph. Nat. Cur. Dec. 11. Ann. viii. Obs. 45.
'Avicenna, Fen. 1. Lib. iv. Tr. ir. Cap. VI. •• Madai, Von Weekselfiebern. Sect. 144. H Eph. Nat. Cur. Dec. III. Ann. ix, and x. Obs. 51.
# Marcellus Donatus, Lib. III. Cap. xiv. p. 291.-Pontanus, De Febr. Conel. L. VIII. $$ Binninger, Obs. Cent. v. N. 64. Wierius, Obs. p. 37.
Gabelchover, Cent. vi. Obs. 74.
Gen. II, cies therefore, that we chiefly meet with those congesAnetus. Intermit- tions in the spleen which are called ague-cakes; as also tent fever. with scirrhosities in the liver, pancreas, and other abdo
minal organs, which by Bonet, Swalwe, Senac, and other and other writers, have been regarded as causes of the disease, but congestions. by Van Hoven, and all the pathologists of the present
day, are more correctly resolved into effects. 11 w j.
Schenck gives a case of congenital quartan, or in which found congenital.
it appeared in an infant immediately after birth *; and Paullini another, in which, though not strictly congeni
tal, it appeared in very early infancy to But such ex Has de
amples are rare. Among other singularities, I may obsingle par
serve that the accession has sometimes been so violent oxysm. as to destroy the patient in the course of the first par
oxysm, of which an instance will be found in Senac , The par while at other times it has been so slight and rapid, that oxysm has
the entire paroxysm has run through its course in ja pleted in a minutes. . .
' sir. 101d The character of the intermittent seems in a considerable degree to depend upon the age or idiosyncrasy of
the individual and the temperament of the atmosphere. Quotidians We find also that variations more usually take place in
than the quotidian than in any other type, which we should, any other perhaps, ascribe to its occurring more frequently in type,
early life, when the frame is more irritable; and to the debility which the constitution suffers from this type above that of any other, in consequence of the greater length of its paroxysms, and the greater brevity of its intervals, by which means the prostrated strength of the
system has no time to rally or recover itself 04-sockey Intermit In this metropolis, from causes which have not been tents pecu- honded down to liarly fre
handed down to us, and which, indeed, do not appear quent in to have been traced at the time, intermittent fevers were London,
more than ordinarily frequent from the year 1781 to to 1785, 1785: and the remarks I have just made apply in an
especial manner to all these!! As a single example, let Gen. II. us select those of 1782, as described by Sir George A Baker and Dr. Reynolds, in an article drawn up by the tent fever. former with an admirable combination of learning and libérality; sound critical judgement, and inquisitive research. wild anders is
“The type of the fever of 1781-2”, says Sir George, Sir George " was either tertian or quotidian; the former being more count of
Baker's accommon in the first part of the winter; the latter, from 1781-2, 4 the middle of February to the end of June.' With respect to the former NOTHING OCCURRED to my observation which is worthy of notice. On the latter, Dr. Reynolds has communicated to me the following remarks : and any addition would be unnecessary relative to a subject which he has so well exhausted."* Is This communication is too long to be copied 'verbally, but it is fully entitled to the praise which the learned Baronet has bestowed upon it. It will be sufficient for our present purpose to transcribe its leading features. ?• Dr. Reynolds, in his communication to Sir George as commu
nicated by Baker, tells us that the quotidian fevers of the above Reynolds. year were irregular in their invasion, and uncommon in their appearance; and that no cases resembled each other except in very few circumstances. The first attack generally commenced with a horror; but the subsequent paroxysms, though often beginning with a sense of cold, were chiefly without horror. The intermission was short and seldom perfect. The symptoms were very severe, and in many cases dangerous, and leaned strikingly to a typhous form. Great and sudden oppression of the head, anxiety, depression of spirits, a dry, parched tongue, yet less covered with hardened mucus than might be expected; a pulse low, quick, and intermitting ; bowels variable; urine dark-red and clear, without any sediment, constituted the ordinary signs. Many had a low muttering delirium; two or three, a laborious respiration; a